Time-driven activity-based costing to improve transparency and decision making in healthcare

Purpose – The purpose of this paper is to discuss the potentialities of innovative accounting tools in supporting “transparency” and “resource allocation” in public hospitals, by describing the implementation of a pilot project of time-driven activity-based costing (TDABC). Design/methodology/approach – An interventionist research (IR) approach has been adopted: two medical doctors, three financial controllers and three researchers were involved. Collection of data used to implement the accounting model is based on hospital databases and interviews. Findings – The information produced may allow a higher coherence between resources and activities. TDABC may enhance transparency and support decisions toward a better organization of work and an informed allocation of resources. Research limitations/implications – Further studies are required to analyze decisions following the implementation of the TDABC model. Originality/value – The accounting literature lacks case studies describing the application of TDABC in hospital settings, despite its good informative potentialities and the limited investment required to introduce TDABC. Moreover, the use of the IR approach and the involvement of medical doctors may help to get coherence between accounting data and clinical work and may support the further diffusion and development of this costing model in hospitals.